More states will pursue expansion of Medicaid health benefits for poor Americans under the Affordable Care Act after Republicans failed to repeal and replace the law.
The American Health Care Act, also known as Trumpcare, would’ve rolled back the ACA’s Medicaid expansion and put restrictions on states that tried to expand such coverage. But Speaker of the U.S. House of Representatives Paul Ryan Friday pulled the ACHA legislation Friday, making, “Obamacare the law of the land,” as he said.
At least two states– Kansas and North Carolina–are already working toward becoming the 32nd and 33rd states to expand Medicaid under the ACA. They would join 31 states plus the District of Columbia that have taken advantage of generous federal funding available under the law, President Obama’s signature legislative achievement, according to the Advisory Board.
And there may be even more states that will resurrect state legislative efforts to expand Medicaid. Before Trump was elected, Georgia, Idaho, Nebraska and South Dakota were considering Medicaid expansion. But Trump’s election, along with Republican control of Congress, prompted these states to put on the brakes for Medicaid expansion when an ACA repeal looked likely. “The effort to expand Medicaid in Georgia just died,” the Atlanta Journal-Constitution said Nov. 9, 2016, the day after Trump won the electoral college.
From 2014 through 2016, the ACA’s Medicaid expansion population is funded 100% with federal dollars. Beginning this year, states gradually have to pick up some costs, but the federal government still picks up 90% or more of Medicaid expansion through 2020. It was a better deal than before the ACA, when Medicaid programs were funded via a much less generous split between state and federal tax dollars.
With the federal funding still part of the ACA, Kansas lawmakers just last week were forging ahead and now have a hurdle lifted with the law in place for the “foreseeable” future, as Speaker Ryan said. A so-called “manager’s amendment” in Ryan’s failed ACHA bill took specific aim at Kansas and North Carolina, making the states “long shots” at expanding Medicaid until Friday’s failed Obamacare repeal.
The Medicaid expansion has been a boon to health insurance giants, including Aetna AET +0.59%, Anthem WLP +%, Centene CNC +0.85%, Humana HUM -0.10% and UnitedHealth Group UNH -1.16%, with substantial Medicaid contracts that have enrolled millions of members.
An expansion in Kansas alone would add another 150,000 people to Medicaid rolls, lawmakers there said last week.
“If you can predict what’s going to happen in Washington, that would be great if we could be sure what’s going to happen. But in the meantime, we have to move ahead as a state,” Vicki Schmidt, the Republican chair of the Kansas Senate Public Health and Welfare Committee said in a report in last week’s Kansas City Star.
The ACA remains in place, so now Kansas and others can more forward with their Medicaid expansions.
– Bruce Japsen I Forbes
